Dissociative (Conversion) Disorders

13/12/2013 by admin | Psychiatry

Definition:  is a condition in which patients present with neurological symptoms such as numbnessblindnessparalysis, or fits without a physiological cause. It is thought that these problems arise in response to difficulties in the patient’s life, and conversion is considered a psychiatric disorder in ICD-10 and DSM-4.

*** It is important to note that the symptom or deficit is not intentionally produced or feigned (as in factitious disorder or malingering)… it is a genuine somatic pathology for the pt ***

Classification / type of disease:


  • Diagnosis is difficult, therefore incidence hard to assess – although it is thought to be around 10-20/100,000/yr.
  • More commonly seen in women (~x6 times).
  • Peak onset is thought to be mid-30s

Presenting symptoms / signs:  

Conversion disorder can present with any motor or sensory symptom including any of the following:

  • Weakness/paralysis of a limb or the entire body (hysterical paralysis or motor conversion disorders)
  • Impaired vision (hysterical blindness) or impaired hearing
  • Loss/disturbance of sensation
  • Impairment or loss of speech (hysterical aphonia)
  • Psychogenic non-epileptic seizures
  • Fixed dystonia unlike normal dystonia
  • Tremor, myoclonus or other movement disorders
  • Gait problems (Astasia-abasia)
  • Syncope (fainting)


Diagnostic investigations:

In diagnosis, it is important to fully rule out neurological disease, feigning/malingering, and to establish a psychological basis. A history of sexual abuse which has been repressed and then reactivated is quite common in conversion illness.




  1. Explanation
  2. Physiotherapy
  3. Occupational Therapy to maintain autonomy in activities of daily living
  4. Treatment of comorbid depression or anxiety if present
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